JAMA:多吃鸡蛋可能增加健康风险
  • 在美国纳入平均年龄为51.6岁的29615名成年参与者,其中44.9%为男性,31.1%为黑色人种;
  • 在中位数为17.5年的跟踪时间内,共发生5400例心血管疾病(CVD)和 6132 例全因性死亡事件;
  • 每天每额外摄入300mg膳食胆固醇或者半个鸡蛋 ,与罹患CVD或发生死亡事件的风险升高具有显著相关性;
  • 胆固醇摄入量的增加是额外摄入鸡蛋带来的主要风险因素;
  • 美国人群中高膳食胆固醇或鸡蛋摄入量会提高罹患CVD或死亡的风险,摄入量的多少影响风险大小。
主编推荐语
小肠君
2015年美国膳食指南调整中,放开了对每日胆固醇和鸡蛋摄入量的限制。然而《JAMA》近期发表的研究显示,美国人群中更多的膳食胆固醇或鸡蛋摄入会提高心血管疾病或死亡的风险,摄入量的多少影响风险大小。该结果对制定或更新膳食指导具有重要参考作用。
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JAMA [IF:157.335]

Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality

膳食胆固醇或鸡蛋摄取与心血管疾病和死亡事件的关联

10.1001/jama.2019.1572

2019-03-19, Article

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IMPORTANCE: Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg consumption is associated with cardiovascular disease (CVD) and mortality remains controversial.
OBJECTIVE: To determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality.
DESIGN, SETTING, AND PARTICIPANTS : Individual participant datawere pooled from 6 prospective US cohorts using data collected between March 25, 1985, and August 31, 2016. Self-reported diet data were harmonized using a standardized protocol.
EXPOSURES : Dietary cholesterol (mg/day) or egg consumption (number/day).
MAIN OUTCOMES AND MEASURES : Hazard ratio (HR) and absolute risk difference (ARD) over the entire follow-up for incident CVD (composite of fatal and nonfatal coronary heart disease, stroke, heart failure, and other CVD deaths) and all-cause mortality, adjusting for demographic, socioeconomic, and behavioral factors.
RESULTS : This analysis included 29 615 participants (mean [SD] age, 51.6 [13.5] years at baseline) of whom 13 299 (44.9%) were men and 9204 (31.1%) were black. During a median follow-up of 17.5 years (interquartile range, 13.0-21.7; maximum, 31.3), there were 5400 incident CVD events and 6132 all-cause deaths. The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic (all P values for nonlinear terms, .19-.83). Each additional 300mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.17 [95%CI, 1.09-1.26]; adjusted ARD, 3.24%[95%CI, 1.39%-5.08%]) and all-cause mortality (adjusted HR, 1.18 [95%CI, 1.10-1.26]; adjusted ARD, 4.43%[95%CI, 2.51%-6.36%]). Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06 [95%CI, 1.03-1.10]; adjusted ARD, 1.11% [95%CI, 0.32%-1.89%]) and all-cause mortality (adjusted HR, 1.08 [95%CI, 1.04-1.11]; adjusted ARD, 1.93%[95%CI, 1.10%-2.76%]). The associations between egg consumption and incident CVD (adjusted HR, 0.99 [95%CI, 0.93-1.05]; adjusted ARD, −0.47%[95%CI, −1.83%to 0.88%]) and all-cause mortality (adjusted HR, 1.03 [95%CI, 0.97-1.09]; adjusted ARD, 0.71% [95%CI, −0.85%to 2.28%]) were no longer significant after adjusting for dietary cholesterol consumption.
CONCLUSIONS AND RELEVANCE : Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.

First Authors:
Victor W Zhong

Correspondence Authors:
Victor W Zhong,Norrina B Allen

All Authors:
Victor W Zhong,Linda Van Horn,Marilyn C Cornelis,John T Wilkins,Hongyan Ning,Mercedes R Carnethon,Philip Greenland,Robert J Mentz,Katherine L Tucker,Lihui Zhao,Arnita F Norwood,Donald M Lloyd-Jones,Norrina B Allen

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